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  • 1
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    Sinonasal adenocarcinoma following styrene exposure in the reinforced plastics industry (2018)
    BMJ Publishing Group
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    Publication Date: 2018-05-18
    Description: Background Sinonasal adenocarcinoma is a rare disease expected to have rare causes and potential for strong risk factors as reflected by the strong association with occupational wood dust exposure. High level styrene exposure is a rare and suspected carcinogen, and this study examines the exposure–response relation between occupational styrene exposure, sinonasal adenocarcinoma and other subtypes. Methods We followed 73 092 styrene-exposed workers from 1968 to 2011 and identified sinonasal cancers in the Danish Cancer Registry. We modelled cumulative styrene exposure and estimated incidence rates and age, sex and wood-industry adjusted ORs. Results During 1 585 772 person-years, we observed nine cases of adenocarcinoma, corresponding to a fivefold non-significantly increased OR for estimates of high versus low cumulative styrene exposure (OR 5.11, 95% CI 0.58 to 45.12). The increased risk was confined to exposure received during the recent 15 years. The other histological subtypes showed no increased risk. Conclusion This study suggests increased risk of sinonasal adenocarcinoma following styrene exposure. The observations are, however, few, confounding from wood dust exposure cannot be ruled out, and additional studies are needed before firm conclusions can be drawn.
    Keywords: Open access, Epidemiology
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 2
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    Occupational health and valid work exposure tools are keys to improving the health of ageing workers (2018)
    BMJ Publishing Group
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    Publication Date: 2018-04-13
    Description: Many countries have increased the legal retirement age due to economic constraints and ageing populations. 1 One important obstacle to raising retirement age is premature ageing caused by difficult and arduous working conditions. 2 3 Nevertheless, even for some countries with retirement ages that may vary according to working conditions, it is particularly challenging to define an optimal retirement age that consistently and fairly determines which workers may be granted earlier retirement due to difficult working conditions. France started by defining exposures in terms of their consequences, that is, the presence of a specific recognised occupational disease or injury. 4 In 2014, the government introduced a new rule requiring employers to evaluate the extent of workers’ exposures to multiple working conditions. The workers could retire earlier depending on the number of years of such exposure. The decision was based on the number of years...
    Keywords: Public health
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 3
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    Sickness absence due to different musculoskeletal diagnoses by occupational class: a register-based study among 1.2 million Finnish employees (2018)
    BMJ Publishing Group
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    Publication Date: 2018-03-28
    Description: Objectives Those in lower occupational classes have an increased risk of sickness absence due to musculoskeletal diseases (MSDs), but studies examining the associations simultaneously across specified diagnostic groups within MSDs are lacking. We examined occupational class differences in the occurrence and length of long-term sickness absence due to different musculoskeletal diagnoses. Methods A 70% random sample of employed Finns aged 25–64 years old at the end of 2013 was linked to data on sickness absence of over 10 working days obtained from The Social Insurance Institution of Finland and occupational class from Statistics Finland. Sickness absences due to MSDs initiated in 2014 were followed until the end of each episode for female (n=675 636) and male (n=604 715) upper non-manuals, lower non-manuals and manual workers. Negative binomial hurdle models were used to analyse the associations. Results Within the studied MSDs, the most common causes of absence were back disorders, particularly back pain, and shoulder disorders. Osteoarthritis, disc disorders and rheumatoid arthritis induced the longest episodes of absence. Clear hierarchical class differences were found throughout, but the magnitude of the differences varied across the diagnostic causes. The largest class differences in the occurrence were detected in shoulder disorders and back pain. The class differences in length were greatest in rheumatoid arthritis, disc disorders and, among men, also in hip osteoarthritis. Conclusions Hierarchical occupational class differences were found across different MSDs, with large differences in back and shoulder disorders. Occupational class and diagnosis should be considered when attempting to reduce sickness absence due to MSDs.
    Keywords: Public health
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 4
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    Leaving the labour market later in life: how does it impact on mechanisms for health? (2017)
    BMJ Publishing Group
    Details
    Publication Date: 2017-11-16
    Description: Objectives Negative associations between non-employment and health among older people are well established and are potentially important for successful ageing. However, opportunities to improve health through re-employment or extending working lives are limited as later-life exits from employment are often unwanted and permanent. We aim to establish a greater understanding of the psychosocial mechanisms underlying non-employment and health associations in older people to identify modifiable pathways through which the negative impact of non-employment can be ameliorated. Methods Using multilevel analysis of four waves of repeated panel data from a representative sample of 1551 older men and women reaching state retirement age in the West of Scotland from 1987/1988 to 2000/2004, we explored respondents' strength of agreement with 20 statements relating to their self-defined employment status, covering themes of functioning, social engagement, self-esteem, mental engagement, stress, and control and autonomy. Results Compared with those in employment, respondents who were retired, unemployed, sick/disabled and home makers were more likely to agree that this resulted in poor social engagement, low self-esteem and, with the possible exception of retirees, reduced mental engagement. Associations were particularly marked among unemployed and sick/disabled respondents who also agreed that their status was a source of worry and prevented them from feeling in control. Conclusion Older people who are not in employment are at higher risk of poor physical and mental health. Interventions targeting psychosocial mechanisms such as social and mental engagement and self-esteem offer potentially valuable opportunities to improve health outcomes and promote successful ageing.
    Keywords: Open access, Epidemiology
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
    Location Call Number Limitation Availability
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  • 5
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    Application of linear mixed-effects model with LASSO to identify metal components associated with cardiac autonomic responses among welders: a repeated measures study (2017)
    BMJ Publishing Group
    Details
    Publication Date: 2017-10-14
    Description: Background Environmental and occupational exposure to metals is ubiquitous worldwide, and understanding the hazardous metal components in this complex mixture is essential for environmental and occupational regulations. Objective To identify hazardous components from metal mixtures that are associated with alterations in cardiac autonomic responses. Methods Urinary concentrations of 16 types of metals were examined and ‘acceleration capacity’ (AC) and ‘deceleration capacity’ (DC), indicators of cardiac autonomic effects, were quantified from ECG recordings among 54 welders. We fitted linear mixed-effects models with least absolute shrinkage and selection operator (LASSO) to identify metal components that are associated with AC and DC. The Bayesian Information Criterion was used as the criterion for model selection procedures. Results Mercury and chromium were selected for DC analysis, whereas mercury, chromium and manganese were selected for AC analysis through the LASSO approach. When we fitted the linear mixed-effects models with ‘selected’ metal components only, the effect of mercury remained significant. Every 1 µg/L increase in urinary mercury was associated with –0.58 ms (–1.03, –0.13) changes in DC and 0.67 ms (0.25, 1.10) changes in AC. Conclusion Our study suggests that exposure to several metals is associated with impaired cardiac autonomic functions. Our findings should be replicated in future studies with larger sample sizes.
    Keywords: Open access, Epidemiology
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
    Location Call Number Limitation Availability
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